return false; } else if (obj_type == "SINGLE_VALUE_RADIO" || obj_type == "SINGLE_VALUE_CHECKBOX") { if (obj.checked) return true; else return false; } else if (obj_type == "RADIO" || obj_type == "CHECKBOX") { for (i=0; i < obj.length; i++) { if (obj[i].checked) return true; } return false; } } function _CF_checkCFForm_1(_CF_this) { if (!_CF_hasValue(_CF_this.FirstName, "TEXT" )) { if (!_CF_onError(_CF_this, _CF_this.FirstName, _CF_this.FirstName.value, "Please Enter Your First name.")) { return false; } } if (!_CF_hasValue(_CF_this.LastName, "TEXT" )) { if (!_CF_onError(_CF_this, _CF_this.LastName, _CF_this.LastName.value, "Please Enter Your Last Name")) { return false; } } if (!_CF_hasValue(_CF_this.Email, "TEXT" )) { if (!_CF_onError(_CF_this, _CF_this.Email, _CF_this.Email.value, "Please Enter a Valid Email Address")) { return false; } } return true; } //-->
 
First Name:
Last Name:
Daytime Phone:
Daytime Fax:
e-mail:
 

 

      

Eshaghian Insurance and Financial Services, Inc.

License# OC73877 
16200 Ventura Blvd. Suite 228
Encino, CA  91436

Phone:(818)906-3666
Fax:(818)783-4312


Email: info@life26.com